Gastric dysplasia in random biopsies: the influence of Helicobacter pylori infection and alcohol consumption in the presence of a lesion

• Published in: Scandinavian journal of gastroenterology 2024, Vol.59 (2), p.125-132
• Main Authors: Ferreira, Ana Isabel, Lima Capela, Tiago, Macedo Silva, Vítor, Xavier, Sofia, Boal Carvalho, Pedro, Magalhães, Joana, Cotter, José
• Format: Article
• Language: English
• Subjects: Alcohol Drinking - adverse effects; Biopsy; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Precancerous Conditions - pathology; Retrospective Studies; Stomach Neoplasms - pathology
• ISSN: 0036-5521; 1502-7708; 1502-7708
• DOI: 10.1080/00365521.2023.2272563

Gastric dysplasia in the absence of an endoscopically defined lesion is rare, usually either a false positive diagnosis or a previously unidentified precancerous lesion during esophagogastroduodenoscopy (EGD). Evaluate factors associated with the presence of an endoscopically visible lesion during follow-up in patients with histologic diagnosis of gastric dysplasia in random biopsies. Retrospective cohort study including patients referred to our institution for gastric dysplasia in random biopsies during Index EGD. Endoscopic evaluation was performed with a high-definition endoscope using narrow band imaging (HD EGD-0). If no lesion was detected, endoscopic surveillance (HD EGD-FU) was conducted within 6 months for high grade dysplasia (HGD) or 12 months for low grade (LGD) or indefinite for dysplasia (IFD). From a total sample of 96 patients, 5 (5.2%) presented with an endoscopically visible lesion during HD EGD-0, while 10 lesions (10.4%) were identified during HD EGD-FU. Patients with infection at Index EDG and with regular alcohol consumption (≥25 g/day) were 8 and 4 times more likely to have an endoscopically visible lesion on HD EGD-FU (  = 0.012 and  = 0.047). In binary logistic regression, both factors were independent predictors of the presence of gastric lesion on HD EGD-FU (OR 9.284,  = 0.009 and OR 5.025,  = 0.033). The presence of an endoscopically visible lesion after the histologic diagnosis of gastric dysplasia in random biopsies was more frequent during HD EGD-FU. infection at Index EGD and regular alcohol consumption were significant predictors of the presence of gastric lesion on HD EGD-FU.